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Full text of "Quick facts about Medicare's new coverage for prescription drugs for people who are nursing home residents or live in certain types of long-term care facilities"

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CENTERS FOR MEDICARE & MEDICAID SERVICES 






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Quick Facts about Medicare's New Coverage 
for Prescription Drugs for people who are 
Nursing Home residents or live in certain 
pes of Long-term Care Facilities 

Starting January 1, 2006, Medicare will offer prescription drug coverage for everyone 
with Medicare. In order to get Medicare drug coverage, you will need to enroll in a 
Medicare prescription drug plan. 

What do I need to know? 

• You can first enroll in a Medicare prescription drug plan from November 15, 2005 
-May 15, 2006. In most cases, if you don't enroll during this period your next 
chance to enroll will be November 15, 2006-December 31, 2006, and you may 
have to pay a higher premium. You won't have to pay a higher premium if you had 
continuous drug coverage from another source that was, on average, at least as 
good as standard Medicare drug coverage. 

• If you are not able to enroll on your own, your authorized representative can enroll 
you in a plan that meets your needs. 

• Some nursing homes and other long-term care facilities have their own pharmacy. 

• If you move into a nursing home or other long-term care facility, you can switch 
Medicare prescription drug plans at that time if you choose to. 

• If you are in a skilled nursing home getting Medicare-covered skilled nursing care, 
your prescriptions generally will be covered by Medicare Part A. 

• There is extra help for people with limited income and resources, including people 
who have Medicaid health coverage and people who receive Supplemental Security 
Income. 



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What do I need to know? (continued) 

• If you have full coverage from Medicaid, your prescription drugs stop being 
covered by Medicaid, and start being covered by Medicare on January 1, 2006. 
You will have continuous coverage. 

• If you have full coverage from Medicaid and live in a nursing home, you will 
pay nothing out of your own pocket. 

• If you have full coverage from Medicaid and live in an Assisted Living or Adult 
Living Facility, or a Residential Home, you will pay a small copayment for each 
covered prescription drug. 

How do I get more information? 

• Read the "Medicare & You 2006" handbook that you get in the mail in October 
2005. 

• Visit www.medicare.gov on the web. Select "Search Tools" to get personalized 
information. 

• Call your State Health Insurance Assistance Program (see your copy of the 
"Medicare & You 2006" handbook for their telephone number). You can also call 
1-800-MEDICARE (1-800-633-4227), or visit www.medicare.gov on the web to 
get the telephone number. TTY users should call 1-877-486-2048. 

• Call 1-800-MEDICARE (1-800-633-4227). TTY users should call 
1-877-486-2048. 

• Look for local Medicare-related events. 



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CMS Pub. No. 11121 
April 2005